Method and system for rehabilitating a medical condition across multiple dimensions

ABSTRACT

A rehabilitation plan for an individual with a medical condition is selected in view of physical dimensions and personal environment dimensions of the individual that can impact successful use of an instrument for treating the medical condition. Measurement results obtained from assessments of respective physical dimensions and personal environment dimensions of the individual are used to define respective diagnostics metrics, and also to generate diagnostic and goal scores for the respective metrics. A rehabilitation plan for the individual is selected in view of the diagnostic and goal scores with the intention of increasing an individual&#39;s compatibility with the plan and the likelihood of success for rehabilitation. The selection of a rehabilitation plan can include querying a database including previously prescribed rehabilitation plans indexed by physical and personal environment dimensions characteristics of respective patients that were prescribed the rehabilitation plans.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application Nos.60/482,675 filed Jun. 26, 2003 and 60/482,159 filed Jun. 24, 2003,assigned to the assignee of this application and incorporated byreference herein. The subject matter of U.S. patent application Ser. No.______, filed Jun. 24, 2004 and entitled “METHOD AND SYSTEM FOR USING ADATABASE CONTAINING REHABILITATION PLANS INDEXED ACROSS MULTIPLEDIMENSIONS”, assigned to the assignee of this application, is related tothis application.

FIELD OF THE INVENTION

The present invention relates generally to rehabilitation of anindividual having a medical condition and, more particularly, to usingquantified representations of personal environment dimensions andphysical dimensions characteristics of an individual having a medicalcondition to select a rehabilitation plan for the individual.

BACKGROUND OF THE INVENTION

It is well known that rehabilitation of many medical conditions, such ashearing loss, central nervous system conditions, high cholesterol,diabetes, obesity, etc., usually requires an individual having a medicalcondition to perform certain actions that are designed to alleviate thecondition, but will not necessarily result in curing or eliminating thecondition. For example, an individual suffering from the medicalcondition of hearing loss is unlikely to ever have perfect hearingagain, despite the use of an instrument, such as a programmable hearingaid, that may be prescribed to address the physical aspects of thecondition. The approach that the medical community typically takes torehabilitate a medical condition, such as hearing loss, is to prescribeuse of an instrument that addresses only some of the physical aspects ofthe medical condition. The instrument is designed to address thephysical aspects of the medical condition, so as to alleviate themedical condition sufficiently to enable the individual to attain whatmost persons would consider to be a more normal lifestyle. Theinstrument will successfully address the physical aspects of the medicalcondition so long as the individual uses the instrument in the mannerspecifically required for the instrument.

For example, hearing loss is a medical condition for which a hearingcompensation device, such as a hearing aid, is usually prescribed toaddress the physical inability of an individual to satisfactorily hearcertain sound frequencies. It is believed that more than 25 millionAmericans suffer from hearing loss, including one out of four peopleolder than sixty-five. Hearing loss may come from infections, strokes,head injuries, some medicines, tumors, other medical problems or evenexcessive earwax. In addition, hearing loss can result from repeatedexposure to very loud noise, such as music, power tools or jet engines.Changes in the way the ear works as a person ages can also affecthearing.

To determine what kind of hearing loss an individual has and whether allthe parts of the individual's ear are functioning, a physician usuallyhas the individual take a hearing test. A health care professional thatspecializes in hearing, such as an audiologist, often gives these tests.As well known in the art, the audiologist performs a professionalhearing test by using an audiometer, i.e., a sound-stimulus-producingdevice, to generate pure tones at various frequencies between 125 Hz and12,000 Hz that are representative of a variety of frequency bands. Theintensity or volume of the pure tones is varied until the individual canjust barely detect the presence of the tone. For each pure tone, theintensity at which the individual can just barely detect the presence ofthe tone is known as the individual's air conduction threshold ofhearing. Although the threshold of hearing is only one physicaldimension among several physical dimensions that characterize thephysical aspects of an individual's hearing loss, it is the predominantmeasure traditionally used to acoustically fit a hearing compensationdevice, such as a hearing aid.

Various hearing compensation devices currently are available that can beprogrammed for rehabilitation of an individual having hearing loss. Ingeneral, the hearing aid devices are programmed based on hearing testsperformed on an individual to determine the individual's hearing loss ata plurality of frequency ranges. For example, U.S. Pat. No. 6,201,875,incorporated by reference herein, describes a method of fitting ahearing compensation device that includes selecting a plurality ofloudness levels for a plurality of frequency ranges and comparing eachloudness level for each frequency for perceived sameness. The loudnesslevels may then be adjusted as needed to achieve perceived samenessacross the frequency spectrum. A gain curve for each frequency iscalculated from the selected plurality of loudness levels. As part ofthe fitting process, the individual sits at a computer or similargraphical user interface with a hearing aid in an ear and responds toloudness of tones in each of twelve frequency ranges. The hearing aiditself emits these test tones in one frequency range at a time, and theindividual adjusts the volume based on individual preferences. Thisprocess is repeated for all twelve frequency ranges, and the results aresent with the hearing aid to its manufacturer for programming. Theprogrammed hearing aid is shipped back to the audiologist and providedto the individual with instructions for operation.

It is noted that the steps performed to program a hearing aid, such asdescribed in the '875 patent, are analogous to the steps that anoptometrist would perform to fit eyeglasses to an individual sufferingfrom vision loss. For example, the optometrist queries an individual asto the clarity of eye charts, adjusts the focal correction by providinga temporary lens and then continues to repeat these steps until thefocal correction is optimized. The optimal correction, called aprescription, is then applied to corrective lenses, which is theinstrument that will be manufactured for the individual to address thephysical aspects of vision loss.

Although the unique and personal characteristics of an individual cansignificantly impact the successful rehabilitation of a medicalcondition that includes the use of an instrument to treat physicalaspects of the condition, the medical community does not typicallyformally integrate and use the results of an assessment of anindividual's unique and personal characteristics, in combination withthe results of an assessment of the individual's physical dimensionsrelating to the medical condition, into the selection of arehabilitation plan for the medical condition. For example, when ahearing aid is fitted to an individual, such as described in the '875patent, the unique and personal characteristics of the individual arenot formally used to design a rehabilitation plan for the individual.The unique and personal characteristics of each individual, or anindividual's personal environment dimensions, can include, for example,the individual's preferences and dislikes, tendencies, psychologicalprofile and the like.

For example, audiologists currently do not select or develop auralrehabilitation plans in view of such personal environment dimensions asan individual's skill in understanding speech, known as speechintelligibility; the likelihood that the individual will experienceambient noise in real-world settings, such as restaurants, theaters andconference rooms, that interfere with hearing conversations, and alsothe nature of the ambient noise that the individual will experience; theimpact of an individual's psychological makeup on the hearingimprovement process, such as an individual's perception of his ownhearing loss severity and the accompanying motivation to correct it; theability of an individual to trace the source of a sound, known aslocalization; an individual's preferences and tendencies, such as inadapting to new technologies, or persistency or practice with adoptingnew behaviors;; an individual's personal preferences in the trade-offbetween the appearance and the performance of a rehabilitationinstrument; and an individual's perception and preference for soundquality. Consequently, many individuals currently are dissatisfied withthe perceived improvement to their hearing resulting from use of hearingaid devices.

It has been found that, in many circumstances, an individual prescribeda hearing aid is under the impression that use of the hearing aid willresult in a level of rehabilitation that will be satisfactory to theindividual, but that the individual's personal and uniquecharacteristics that have not been accounted for in the prescription ofthe hearing aid make it unlikely that the individual will ever achievesuch level of rehabilitation. The individual thus becomes disappointed,oftentimes very quickly following initial use of the hearing aid. As ishuman nature, the individual expresses his dissatisfaction concerningthe use of a hearing aid to others. The perceptions of other individualswho could benefit from use of a hearing are now adversely affected basedon hearing of another's dissatisfaction, such that others will be lesslikely to seek medical assistance in connection with their hearing loss.Studies have found that about twenty percent of hearing aid users returntheir hearing aids for refunds, while the remainder experiencediminished hearing aid performance and, thus, diminished quality oflife.

In addition, current techniques for rehabilitating a medical condition,such as a hearing loss, do not include an easily usable and readilyaccessible means to store systematically in a databaseindividual-specific information concerning personal environment andphysical dimensions characteristics and the rehabilitation plansprescribed to the individual. Further, current medical conditionrehabilitation techniques do not provide for ease of access and use ofsuch a rehabilitation database for learning purposes, and also forselecting a rehabilitation plan for an individual with a medicalcondition based on similarities between the characteristics of thepersonal environment and physical dimensions of the individual and thecharacteristics of the personal environment and physical dimensionscorresponding to rehabilitation plans included in the database.

Therefore, there exists a need for integrating quantified results of anassessment of personal environment and physical dimensions ofindividuals into the process of selecting a rehabilitation plan for anindividual, and for providing ease of access to a database containingrehabilitation plans indexed by corresponding personal environment andphysical dimensions information for use in the rehabilitation planselection process.

SUMMARY OF THE INVENTION

In accordance with the present invention, a plan for rehabilitating anindividual having a medical condition is selected by assessing personalenvironment and physical dimensions of the individual, and thenquantifying measurement information obtained from the assessment of thedimensions so that scores representative of the results of therespective assessments can be generated. The scores for the respectivepersonal environment and physical dimensions of the individual, andindividual profile information also obtained from the assessments, arethen used to select a rehabilitation plan.

In a preferred embodiment, the selection of a rehabilitation planincludes searching a rehabilitation database for the medical conditionto identify a matching rehabilitation plan. The database includes, foreach of a plurality of personal environment and physical dimensionsassociated with the medical condition, a plurality of rehabilitationplans previously prescribed to patients, and optionally rehabilitationplans generated from performing interpolations using information frompreviously prescribed rehabilitation plans. The stored rehabilitationplans are indexed by scores generated from the results of respectivepersonal environment and physical dimensions assessments of patients, orby scores for respective personal environment and physical dimensionsgenerated from the interpolations. A rehabilitation plan is selectedfrom the database by matching the score for at least a first of theassessed dimensions of the individual with the score corresponding to astored rehabilitation plan associated with the first dimension, wherethe first dimension is either a personal environment dimension or aphysical dimension.

In a further preferred embodiment, the database is updated usingfeedback obtained from an individual to whom a selected rehabilitationplan is prescribed and progress results concerning the prescribed plan.For example, the plan prescribed to the individual, or a variation ofthe prescribed plan modified to the individual's preferences, isidentified in the database indexed by the dimension the prescribed planaddresses and also the individual's score for the dimension. Inaddition, the prescribed plans in the database can include annotationinformation describing rehabilitative progress of the individual andwhether a rehabilitation goal was successfully attained.

In a preferred embodiment, an assessment of an individual having hearingloss is performed to obtain measurement information on physicaldimensions of hearing loss, such as on volume and pitch, and also onpersonal environment dimensions that can impact use of a hearing aiddevice to address the physical aspects of hearing loss. The personalenvironment dimensions can include, for example, speech intelligibility,real-world needs, critical success factors, localization, appearance andperformance trade-offs and quality preferences. The measurementinformation for each of the respective dimensions is normalized into adiagnostic metric from which diagnostic scores can be generated for usein searching a centralized database that can be remotely accessed usingconventional communications techniques. The database includes previouslyprescribed aural rehabilitation plans indexed by diagnostic scoresobtained from the results of assessments of respective physical andpersonal environment dimensions of the patients to whom therehabilitation plans were respectively prescribed. The databaseoptionally includes aural rehabilitation plans, and associated scoreinformation, generated from interpolations performed using informationrepresentative of the previously prescribed aural rehabilitations storedin the database. The database is searched with respect to one or more ofthe dimensions of the individual to retrieve stored aural rehabilitationplans that match the characteristics of the respective one or moredimensions of the individual. The selected plans that are prescribedconstitute a custom aural rehabilitation program, which preferablyincludes the use of a hearing aid device, and that the individual ismore likely to follow and result in the individual attaining what theindividual considers to be a satisfactory level of rehabilitation. Theretrieved plans further preferably includes annotation information thatcan guide an audiologist whether the plan is suitable for theindividual, in view of the individual's personal environment andphysical dimensions characteristics.

BRIEF DESCRIPTION OF THE DRAWINGS

Other objects and advantages of the present invention will be apparentfrom the following detailed description of the presently preferredembodiments, which description should be considered in conjunction withthe accompanying drawings in which like references indicate similarelements and in which:

FIG. 1 illustrates a set of metrics used to diagnostically assessphysical dimensions and personal environment dimensions of the hearingcapability of an individual in accordance with the present invention.

FIG. 2 is a preferred hearing health system, in accordance with presentinvention, for assessing physical dimensions and personal environmentdimensions of an individual having hearing loss and for storing in acentralized database profile information and scores representative ofthe measurement information obtained from the assessments.

FIG. 3 is a system diagram of an audiologist prescribing an auralrehabilitation plan to an individual with hearing loss using the hearinghealth system of FIG. 2.

FIG. 4 illustrates a preferred method of prescribing an auralrehabilitation plan to an individual with hearing loss using the hearinghealth system of FIG. 2.

FIG. 5 is a representative database table for use in developing an auralrehabilitation program for an individual with hearing loss using thesystem of FIG. 2.

FIG. 6 is a table showing an individual hearing profile at specificamplitudes for numerous frequencies and the amplification factor neededto adjust hearing to a normal level.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides for system and method for selecting arehabilitation plan for an individual having a medical condition in viewof the unique and personal and also physical characteristics of theindividual. The invention is based on the recognition that unique andpersonal characteristics of the individual, or the individual's personalenvironment dimensions, and also physical characteristics of theindividual, or the individual's physical dimensions, can impact whetheran instrument, such as an electronic device, medication, diet control orcontrolled exercise of selected physical structures in the individual'sbody, for addressing physical dimensions of the medical condition, willbe effectively used by the individual as prescribed so that theindividual succeeds in attaining a level of rehabilitation that theindividual considers to be satisfactory. The invention integratesresults of an assessment of the personal environment and physicaldimensions of an individual having a medical condition into theselection of a rehabilitation plan by quantifying measurementinformation obtained from the assessments so that scores representativeof the individual's dimensions characteristics can be used to select arehabilitation plan. The selection of a rehabilitation plan preferablyincludes the use of a database containing previously prescribedrehabilitation plans, where the plans are indexed by quantified resultsof assessments of the personal environment and physical dimensions ofthe respective patients to whom the corresponding plans were prescribed.The database also can contain rehabilitation plans, with associatedindexing information, developed using interpolation techniques from thepreviously prescribed rehabilitation plan information stored in thedatabase. Further, the database preferably includes annotationinformation for respective rehabilitation plans that can further guide adecision as to which of a plurality of plans selected from the databaseshould be prescribed to an individual. By customizing the rehabilitationplan in view of the results of an assessment of the dimensions of theindividual having the medical condition, one or more rehabilitationplans can be selected to form a rehabilitation program for theindividual that results in higher rates of success in attaining a levelof rehabilitation that the individual considers to be satisfactory.

The personal environment dimensions of an individual can be categorizedas constituting an individual's emotions or “heart,” an individual'srational or objective behavior or “mind” and an individual's physicalcharacteristics or “body.” These categories of dimensions are assessedto assist in the identification of a rehabilitation plan that, for thespecific individual, will likely succeed in attaining a level ofrehabilitation that the individual considers to be satisfactory, in viewof the personal environment dimension characteristics of the individual.

The heart category of personal environment dimensions is associated withemotions and perceptions, such as whether an individual would feel oldor young based on use of a specific instrument as part of arehabilitation plan. The heart category also can represent the degree ofemotional anguish an individual suffers based on the medical conditionitself. Successful rehabilitation is more likely, i.e, an individual ismore likely to use a prescribed instrument, when the type of prescribedinstrument is selected in view of the individual's perceptions. Forexample, an aural rehabilitation plan is likely to be more successful ifthe decision to prescribe a larger versus a smaller, relativelyinvisible hearing aid is made in view of an individual's perceptionsconcerning the size of the device itself.

The mind category of personal environment dimensions is associated withan individual's rational thinking, such as how an individual wouldtradeoff a larger or smaller instrument with the price of theinstrument.

The body category of personal environment dimensions is associated withthe impact that the application of the instrument to one portion of theindividual's body will have on the rest of the individual's body, suchas, for example, whether the individual will have to make additionalphysical adjustments based on application of the instrument. Theindividual may find that the application of a particular instrument toone part of the body requires time for training and exercising otherunrelated parts of the body. For example, an individual may be moretolerant of a hearing aid that is located behind the ear versus in theear canal, because the former creates less discomfort. In addition, anindividual having hearing loss and limited manual dexterity may prefer aremotely controllable hearing aid that is larger to allow for ease ofadjustment and battery replacement.

For purposes of highlighting the features of the present invention, thepresent inventive technique of integrating quantified personalenvironment and physical dimensions characteristics of an individualwith a medical condition into the selection of a rehabilitation plan,where the plan preferably includes application of an instrument fortreating a physical aspect of the medical condition, is described belowin connection with selection of an aural rehabilitation plan for anindividual having hearing loss in view of personal environment andphysical dimensions characteristics of the individual, where the auralrehabilitation plan preferably includes use of a programmable ornon-programmable hearing aid. It is to be understood that the presentinventive technique can be readily applied to selecting a rehabilitationplan for any of various medical conditions, for example, central nervoussystems conditions such as Alzheimer's disease, cardiologicalconditions, high cholesterol, joint replacement, diabetes, hypertension,schizophrenia and other like medical conditions, for which an instrumentlikely will be prescribed to address physical aspects of the conditionto alleviate the condition at least in part.

FIG. 1 is a graphical representation of an exemplary set of metrics 100for an individual with hearing loss 105 that is used, in accordance withthe present inventive technique, to quantify the results of diagnosticassessments of personal environment dimensions and physical dimensionsof the individual 105. As discussed in detail below, diagnostic scoresand goal scores generated for the respective metrics, and individualprofile information, are used to select rehabilitation plans for theindividual. The selected plans are included in a rehabilitation programthat is customized to the individual's personal environment and physicaldimensions characteristics and, thus, has a high likelihood ofsuccessfully attaining a level of rehabilitation that is satisfactory tothe individual. Referring to FIG. 1, the metrics 100 include metricscorresponding to physical dimensions of hearing loss, such as a volumemetric 111 and a pitch metric 112, and metrics corresponding to personalenvironment dimensions of an individual having hearing loss, such as aspeech intelligibility metric 113, a real-world needs metric 114, anindividual's critical success factors metric 115, a localization metric116, an appearance and performance trade-off metric 117 and a qualitypreferences metric 118. In an alternative preferred embodiment, thephysical dimension associated with an individual's ear canalcharacteristics is also assessed for defining a corresponding metric. Inaddition, FIG. 1 shows, for each of the metrics 100, a goal score 130, adiagnostic score 140, a plurality of steps to reach a goal 150 and alowest possible score 190. Further, FIG. 1 identifies which of themetrics 100 constitute binaural impact indications 160.

Typically, the individual 105 on whom an assessment is performed inconnection with each of the metrics 100 has experienced loss of hearingdue to physical damage of hearing cilia inside one or both ears.Measurement information obtained from an assessment of the-respectivedimensions is used to define corresponding metrics 100, and then anindividual's scores for the respective metrics 100 are generated alsobased on the measurement information. The measurement information forthe respectively assessed dimensions is preferably converted to a scalein a range which provides that the individual's scores for all of themetrics can be applied as a percentage between a lowest possible score190 and a perfect score 120.

The dimensions corresponding to the metrics 100 in FIG. 1, which areexemplary metrics corresponding to physical and personal environmentdimensions associated with an individual having hearing loss, aredescribed in detail below.

Volume metric 111 corresponds to an assessment of a physical dimensionand represents the amplitude of a sound wave. Pitch metric 112 alsocorresponds to an assessment of a physical dimension and represents thefrequency of a sound wave. The measurement information used to definethe metrics 111 and 112 is obtained by an audiologist using techniquesfor determining an individual's capability of hearing within anamplitude and frequency range that are part of standard audiologisttests today. For example, in a well known method of testing for volumeand pitch hearing loss in individuals, the threshold of an individual'shearing is typically measured using a calibratedsound-stimulus-producing device and calibrated headphones, which areknown as an audiometer. The matrix of measurements represents avariation of pitch versus volume.

FIG. 6 illustrates an exemplary database table 600 that is typicallyused to store pitch versus volume testing data that can be used todefine the metrics 111 and 112 and generate individual scores for themetrics 111 and 112 in accordance with the present invention. Referringto FIG. 6, the table 600 includes a normal hearing frequency range 610,an amplitude range 620, an example of individual hearing values 630, anexample of normal hearing values 640, an example of amplificationfactors 650 and an example of perceived hearing values 660. Althoughhumans hear at frequencies ranging from 15 to 20,000 hertz (Hz), thenormal hearing frequency range 610 is narrower, extending from 250 to12,000 Hz. During a hearing test, an audiologist may choose to testsounds of different frequency ranges across a series of amplitudes.Amplitude range 620 shows a typical range of 30 to 110 decibels (dB).Individual hearing values 630 shows an example of decibel levels byfrequency that an individual may hear at 110 dB. Normal hearing values640 shows an example of the decibel levels by frequency that theindividual should hear at 110 dB, and amplification factors 650 showsthe difference between individual hearing values 630 and normal hearingvalues 640 at 110 dB. As well known in the prior art, an audiologistadjusts an individual's hearing aid by having a digital signal processorof a hearing aid programmed using amplification factors 650. The finalperceived hearing, however, may still be deficient, as indicated by theperceived hearing values 660.

Referring again to FIG. 1, the volume versus pitch measurementinformation, which preferably is obtained from a table having the formof the table 600, is normalized for each of the metrics 111 and 112 intoa signal metric that is a linear scale from lowest possible score 190 toperfect hearing score 120. The generation of scores based on themeasurement information and consistent with the defined metrics 111 and1 12 could be, for example, as simple as an average of all volume andpitch scores where perfect hearing is 100% and worst case hearing is 0%.

Speech intelligibility metric 113 corresponds to an assessment of apersonal environment dimension and quantifies the ability of anindividual to hear speech sounds, such as spoken words and sentences, aspart of a normal conversation. Tests to determine speech intelligibilitymetric 113 are conducted by an expert, such as an audiologicalprofessional, using a series of most commonly spoken words andsentences. The individual with hearing loss responds as to how he or shehears selected words and sentences. As is well known in the art, typicalspeech sounds occur in the form of a “speech banana.” Assessment ofspeech intelligibility is performed by reading a series of words to anindividual at various amplitudes and looking for an accurate hearingresponse from the individual. The responses are readily converted intomeasurements at different volumes for each of the spoken words. Theareas of the “speech banana” that contain letter sounds that are harderfor the subject to hear are noted. In accordance with the presentinvention, a rehabilitation plan corresponding to an assessment of thespeech intelligibility dimension will emphasize these letter sounds thatare harder to hear, such as by including more practice words for theseletter sounds than the letter sounds that the individual can hear moreeasily.

Real-world needs metric 114 corresponds to an assessment of a personalenvironment dimension and quantifies the hearing capability of anindividual that corresponds to the individual's lifestyle and behavioralneeds. It is well known that hearing capabilities are significantlyaffected by lifestyle. For example, an elderly individual living in arural area can be exposed to a quieter environment and has a differentreal-world needs metric 114 than a younger individual working as aconstruction worker in an urban area. Measurement information fordefining the real-world needs metric 114 can be obtained by simplyasking a series of questions of the individual. The questions caninclude, for example, whether the individual spends significant amountsof time watching television, attending religious ceremonies or attendingcocktail parties.

Individual's critical success factors metric 115 corresponds to anassessment of a personal environment dimension and quantifies anindividual's preferences, tendencies and capabilities. Individual'scritical success factors metric 115 can be thoroughly tested by highlyqualified professionals, such as audiologists, using simple or complextests prepared by psychologists. For example, a simple test determinesthe preference of the individual 105 for electronic devices, whereasmore complex tests, such as Myers-Briggs or the Learning StylesInventory, determine the impulsivity, preferred learning style,discipline and attention span of the individual 105. Measurementinformation for defining an individual's critical success factors metric115 can be obtained by simply noting responses of the individual to aseries of questions.

Localization metric 116 corresponds to an assessment of a personalenvironment dimension and quantifies the ability of an individual totrace the source of a sound. For example, an individual with a deficientlocalization metric 116 may incorrectly identify the dimensions of anenclosed room due to his inability to trace sound rebounding from thewalls, or may incorrectly judge the rate or direction of an approachingvehicle. State-of-the-art virtual reality (VR) techniques can be used totest and assess the individual's localization metric 116. For example,one VR technique employs a head-mounted display (HMD), which consists oftwo miniature displays that are mounted in front of the user's eyes witha head mount. Special optics enable the user to view the miniaturescreens. The HMD also contains two headphones, so that the user may alsoexperience the virtual environment aurally. The HMD is normally fittedwith a head tracker. The position (x, y, z) and orientation (yaw, pitch,roll) of the user's head is tracked by means of the head tracker. As theuser looks around, the position and orientation information iscontinuously relayed to the host computer. The computer calculates theappropriate view (virtual camera view) that the user should see in thevirtual environment, and this is displayed on the miniature displays.Based on these procedures, the audiologist can easily obtain measurementinformation need to define the individual's localization metric 116.

Appearance/performance trade-off metric 117 corresponds to an assessmentof a personal environment dimension and quantifies an individual'spersonal preference regarding the trade-off between the appearance andthe performance of a device. For example, a first group of individualsmay prefer electronic devices that are aesthetically pleasing and maynot be very concerned with the performance of the devices or whether thedevices are visible to others or not; a second group of individuals mayprefer performance over aesthetics or visibility; and a third group mayprefer to balance all of the above aspects. Measurement information todefine the appearance/performance trade-off metric 117 can be obtained,for example, by noting an individual's responses to a series ofquestions.

Quality preferences metric 118 corresponds to an assessment of apersonal environment dimension and quantifies an individual's perceptionof and preference for sound quality. An individual's preferences for aspecific quality sound can be viewed in terms of a personal graphicequalizer, where the individual has the capability to hear all soundfrequencies but prefers to emphasize or deemphasize certain frequencies.Quality preferences metric 118 can be tested by exposing an individualto a wide range of tones and sounds and asking him whether he likes thequality of the sound. For example, an individual who dislikes soundslike air conditioning in a room can be tested for his preferencesrelating to a variety of sounds that are similar to air conditioning ina room. Measurement information for defining the quality preferencesmetric 118 can be obtained simply by noting responses to a series ofquestions. Based on this measurement information, a rehabilitation plancan be selected in accordance with the present invention that includesuse of a hearing aid that is programmed to reduce the volume of thedisliked sounds.

Similar to the normalization performed on the volume versus pitchmeasurement information for defining the volume metric 111 and pitchmetric 112, the measurement information obtained from an assessment ofthe personal environment dimensions corresponding to the metrics 113-118are respectively normalized to define signal metrics that are each alinear scale from lowest possible score 190 to a perfect score 120.

Referring to FIG. 1, a diagnostic score 140 for each of the metrics 100is generated based on the measurement information for the associateddimension and in view of the corresponding defined metric 100. Forexample, the diagnostics score 140 for each of the metrics 100 isdetermined prior to the initiation of hearing correction remedies by theaudiologist who performed the respective assessments of the dimensionsof the individual. A goal score 130 is a best score that an individualcan expect to obtain for a dimension, based on hearing assistanceadministered through use of a hearing aid, given the extent of physicalloss inside an ear. As described below, for some metrics, a perfectscore 120 that is different from a goal score 130 may not exist.

If an objective measurement can be performed to determine whatconstitutes a perfect condition for a dimension, such as can beperformed for the dimensions corresponding to the metrics 111, 112, 113and 116, a lowest possible score 190, a diagnostic score 140, a goalscore 130 and a perfect score 120 can be generated for the metriccorresponding to the dimension. For example, for the metric 112 whichconcerns an individual's capability to hear sound at all frequencies,the lowest possible score 190 is the circumstance where the individualis incapable of hearing sound at any frequency; the diagnostic score 140is the individual's reduced capability to hear at specific frequenciesdue to hearing loss; the goal score 130 is the best possible level ofrehabilitation, i.e., improvement in hearing, for the individual in viewof the hearing loss suffered by using a hearing aid as part of arehabilitation plan; and the perfect score 120 is a level thatconstitutes perfect hearing, i.e., the capability to hear allfrequencies, and that the individual can never attain even through useof hearing aid because of the physical loss inside an ear. Thegeneration of a diagnostic score based on the measurement informationcorresponding to each of the metrics 111, 112, 113 and 116 could be, forexample, as simple as summing all scores where a perfect hearing scoreis 100% and worst case hearing is 0%.

Alternatively, if an objective measurement cannot be performed todetermine what constitutes a perfect score for the dimension, such ascannot be performed for the dimensions corresponding to the metrics 114,115 and 117, only a lowest possible score 190, a diagnostic score 140and a goal score 130 can be generated for the metric corresponding tothe dimension. For these dimensions, the perfect score 120 does notexist, or otherwise is considered to be the same as the goal score 130.

In addition, even if an objective measurement cannot be performed todetermine what constitutes a perfect score for the dimension, in somecircumstances a perfect score 120 can still be generated for the metriccorresponding to the dimension. For example, for the quality preferencesmetric 118, a perfect score 120 can constitute hearing performance thatthe individual previously was capable of attaining and remembers but, inview of the hearing loss, cannot ever again achieve, even with use of ahearing aid.

Referring still to FIG. 1, for some of the metrics 100, the goal score130 does not exist or is the same as the diagnostic score 140. Forexample, for the appearance/performance tradeoff metric 117, thediagnostic score representative of an individual's preference for anaesthetically pleasing instrument, despite it only having basicfunctionalities, may not be likely to change in the course ofrehabilitation. Therefore, for the metric 117, there is no goal score orthe goal score 130 is the same as the diagnostic score 140 and also theperfect score 120.

As discussed below, the individual's score for the metric 117 can beused to select rehabilitation plans to be included in an overallrehabilitation program that will improve the chances of successful useof a hearing aid device by the individual. For example, based on thediagnostic score for the metric 117, the audiologist would onlyprescribe the use of an aesthetically pleasing, basic functioninghearing aid and accordingly select other rehabilitation plans tosupplement the functional shortcomings of the prescribed hearing aid. Inaddition, the goal score and diagnostic score for the metric 117 canreflect the willingness of the individual to potentially accept largerhearing aids. An appropriate rehabilitation plan for the metric 117,based on such scores, would involve use of a moderately sized hearingaid.

For purposes of illustration, FIG. 1 is shown with exemplary diagnostic,goal and perfect scores for each of the metrics 100. Referring again toFIG. 1, line 147 connects the diagnostic scores 140 for each of themetrics 100 to define a bounded area that corresponds to a cumulativediagnostic score 145. The cumulative diagnostic score 145, for example,can constitute the sum of the diagnostics scores 140 for the metrics100.

In addition, line 137 connects the goal scores 130 for each of themetrics 100 and line 127 connects the perfect scores 120 for each of themetrics. The bounded area defined between the lines 137 and 147corresponds to a cumulative goal score 135. The cumulative goal score135, for example, can constitute the sum of the absolute differencebetween the goal scores 130 and the diagnostic scores 140 for each ofthe metrics 100. The bounded area defined between the lines 127 and 137corresponds to a cumulative perfect score 125. The cumulative score 125represents the individual's overall present hearing capabilities and,for example, can constitute the sum of the absolute difference betweenthe perfect scores 120 and the diagnostic scores 130 for each of themetrics 100. Thus, the cumulative score 135 represents how much overallimprovement to hearing is possible relative to the cumulative score 145if the individual uses a hearing aid as a part of rehabilitation planselected in accordance with the present invention. The cumulative score125 represents hearing performance that the individual can never regain.It is to be understood that the metrics 100 shown in FIG. 1 inillustrative manner, and that the cumulative scores 125, 135 and 145 canbe generated so long as a plurality of dimensions of an individual areassessed.

Steps to reach a goal 150 is the step-by-step path necessary for theindividual 105 to progress from diagnostic score 140 to goal score 130for a specific metric. Typically, steps to reach goal 150 is an auralrehabilitation plan prescribed by a speech pathologist for theindividual 105, Aural rehabilitation plans are gradual training andacclimation programs designed to bring individuals with hearing loss upto their best possible hearing level.

Referring again to FIG. 1, metrics 100 that affect the left and rightears of an individual with different severity are identified with anbinaural impact indication 160. For example, diagnostic score 140 forvolume metric 111 for the left ear of an individual can be differentfrom diagnostic score 140 for volume metric 111 for the right ear.Binaural impact indication 160 can be helpful in prescribing an auralrehabilitation plan for a particular individual, because different stepsto reach goal 150 can be prescribed for each ear. For example, arehabilitation plan that accounts for binaural indications can includeCD training with headphones that directs sound only to one ear.

In accordance with the present invention, measurement informationobtained from assessing the personal environment and physical dimensionsof an individual is quantified so that it can be readily used to assistand guide in the selection of a rehabilitation plan for an individualhaving a medical condition, such as, for example, the selection of anaural rehabilitation plan by an audiologist. Scores corresponding todiagnostics metrics generated from the measurement information, and alsoprofile information obtained from the assessments, are used to selectrehabilitation plans that, in combination, form a rehabilitation programthat has a high probability of successfully attaining a level ofrehabilitation that the individual considers to be satisfactory. Theselected rehabilitation plans impact the type of instrument selected totreat physical aspects of the medical condition and the type ofrehabilitation efforts that the individual is directed to perform inconnection with the use of the selected instrument. As therehabilitation program is customized to the individual, the individualis more likely to adhere to the rehabilitative program, which includesuse of the instrument. Thus, for an individual having hearing loss,scores generated for the metrics corresponding to respective personalenvironment and physical dimensions of the individual assist in theselection of a rehabilitation plan including the use of a hearing aid.As the individual's personal environment and physical dimensionscharacteristics are accounted for in the selection of rehabilitationplans, the individual is highly likely to use the hearing aid and alsoperform other treatment actions required by the rehabilitation plans soas to successfully reach a level of rehabilitation that is in accordancewith the individual's expectations.

FIG. 2 illustrates a health hearing system 200 for assessing thedimensions of the individual 105, and for generating scores for therespective metrics 100 corresponding to the assessed dimensions that canassist in selection of a rehabilitation plan in accordance with thepresent invention. Referring to FIG. 2, the system 200 includes ahearing test unit 215 containing a test administration computer 220. Thecomputer 220 is coupled to a set of conventional headphones 225, aconventional keyboard 230 and a conventional monitor 235, and contains aseries of hearing test programs 240. A network 250 couples the computer220 to a central hearing health computer system 260. The central hearinghealth computer system 260 includes a database 263. The database 263includes a quantity of individual profile information 265, severalindividual test results 267 and several aural rehabilitation plans 269.

The hearing test unit 215 can be used to perform conventional hearingtests on an individual 105, and to ask questions of an individual, suchas Myers-Briggs test questions, and record the individual's responses.For example, the conventional monitor 235 can graphically display testfrequencies and amplitudes for the individual 105 during testing or listquestions with potential answers for selection by the individual.

The network 250 is a standard Internet connection, or alternatively is aWAN, LAN or other network configuration. Network 250 is thecommunication infrastructure between central hearing health computersystem 260 and hearing test unit 215. Network 250 allows central hearinghealth computer system 260 to be located remotely from hearing test unit215, thereby allowing central hearing health computer system 260 theopportunity to serve as a central point for a large number of testadministration computers 220.

Test administration computer 220 runs a series of current hearing testprograms 240, which can be suitably updated from the system 260 over thenetwork 250, and stores the results of the tests in the database 263 ofcentral hearing health computer system 260. Test administration computer220 may also have optional local database storage (not shown) that cantemporarily store test results.

Central hearing health computer system 260 is a centrally locatedcomputer system that is connected to network 250, and is capable ofperforming all normal computer functions, such as reading and writingdata to database 263, reading and writing data to a display monitor (notshown), communicating through network 250 and executing stored programsto access and use data stored in database 263.

Database 263 preferably is a central database repository within centralhearing health computer system 260. The data stored within database 263is classified into three main areas, namely, individual profileinformation 265, individual test results 267 and aural rehabilitationplans 269 individual profile information 265 includes, for example, suchpersonal information as an individual's name, contact information, ageand career profile. Individual test results 267 are the results ofhearing tests or hearing loss related assessments performed onindividuals with hearing loss. Aural rehabilitation plans 269 storesrehabilitation plans prescribed to individuals, preferably in respectiveaural rehabilitation plan records. The plan included in a record isindexed by individual profile information and diagnostic and goal scorescorresponding to assessment of respective personal environment andphysical dimensions characteristics of the individual to which the planwas prescribed. In addition, in an alternative preferred embodiment, therehabilitation plans stored in the plans 269 include rehabilitationplans, and associated indexing information, generated by performingconventional interpolation techniques using information concerning thepreviously prescribed rehabilitation plans stored in the records in theplans 269. The use of the database 263 to select a rehabilitation planis explained in greater detail in the text accompanying the descriptionof FIGS. 3-5.

Referring again to FIG. 2, in an exemplary operation of the healthhearing system 200, individual 105 with hearing loss wears headphones225 and uses keyboard 230 and monitor 235 to take a hearing test at testadministration computer 220. As part of the hearing test, the computer220 executes the series of hearing test programs 240 to collect profileinformation and assess physical dimensions and personal environmentdimensions of the individual 105 corresponding to the set of metrics100, which include the metrics 111-118. The profile information for theindividual 105 is stored in individual profile information 265, andscores generated from the measurement information obtained from thehearing tests corresponding to the respective metrics 100 are stored inindividual test results 267. Central hearing health computer system 260then analyzes individual profile information 265 and individual testresults 267 to select one or more aural rehabilitation plans for theindividual 105. The selected plan that is prescribed to the individual105 is then stored in an aural rehabilitation plan record in auralrehabilitation plans 269, where the plan is indexed by the correspondingscores and profile information for the respective metric 100 of theindividual 105.

Thus, the individual 105 is assessed for physical dimensions associatedwith hearing loss, and scores are computed based on measurementinformation obtained from the assessment respectively for each of thevolume metric 111 and pitch metric 112. In addition, preferably whilethe individual with hearing loss is also at the audiologist's office,the personal environment dimensions of the individual 105 are assessed,such as the dimensions corresponding to a speech intelligibility metric113, real-world needs metric 114, individual's critical success factorsmetric 115, localization metric 116, appearance/performance trade-offmetric 117 and quality preferences metric 118, and then respectivescores are computed based on measurement information obtained from theseassessments. All of the scores generated for the respective metrics 100of the individual 105 are stored in individual test results 267 and usedto select one or more aural rehabilitation plans. The selected auralrehabilitation plans, indexed by the individual profile information andthe individual's scores for the diagnostic metrics corresponding to theselected plans, are stored as aural rehabilitation plan records in therehabilitation plans 269. As described below in connection with FIGS. 3and 4, an audiologist or other hearing professional can later access andsearch aural rehabilitation plans 269 to select an aural rehabilitationplan for another individual with hearing loss based on matching ofindividual scores for respective diagnostic metrics with scores for thesame respective metrics that index aural rehabilitation plans stored inthe database 263.

It is to be understood that the assessments of physical dimensions andpersonal environment dimensions performed in connection with selectingan aural rehabilitation plan for an individual with hearing loss arereadily adaptable for use in assessing physical dimensions and personalenvironment dimensions of an individual having any type of medicalcondition in connection with prescribing an overall rehabilitationprogram including rehabilitation plans that may or may not involve useof an instrument addressing physical aspects of the condition.

FIG. 3 illustrates a system 300 for selecting an aural rehabilitationplan for the individual 105 by accessing information stored in thedatabase 263 of the system 260. Referring to FIG. 3, the system 300includes the central hearing health computer system 260 of the system200, which is the same system 200 described above in connection withFIG. 2, and an audiologist 310. Audiologist 310 is a highly trained andlicensed hearing health professional, such as a physician, and ispreferably certified to prescribe a remedy, such as an auralrehabilitation plan, for the individual 105.

In accordance with the present invention, the audiologist 310 selects arehabilitation plan for the individual 105 by searching the database263, which contains, a plurality of rehabilitation plans indexed by anprofile information and scores for the metrics corresponding torespective personal environment and physical dimensions associated withthe condition of hearing loss. The selecting includes comparing theprofile information and also the scores for a metric corresponding to atleast a first of the physical dimensions and the personal environmentdimensions for the individual 105 with rehabilitation plans in the plans269 associated with the same metric, and then selecting, from thecompared plans of the plans 269, a plan having matching profileinformation and scores.

Referring to FIG. 3, in a preferred process for selecting an auralrehabilitation plan in the system 300, audiologist 310 retrieves anaural rehabilitation plan, selected in accordance with presentinvention, from aural rehabilitation plans 269 and prescribes it to theindividual 105. After the plan is prescribed to the individual 105, theaudiologist can update the records in the aural rehabilitation plans 269of the database 263 based on feedback received from the individual orthe resulting rehabilitative progress of the individual. For example,the feedback can be used to define a new aural rehabilitation plan for ametric associated with a personal environment dimension. The new plan isincluded as a new record in the plans 269 for the appropriate metric andis indexed by scores and profile information of the individual fromwhich the feedback was received. Alternatively, the feedback or theprogress results can be used to annotate the aural rehabilitation planrecord for the individual which includes the prescribed plan. Thefeedback, for example, can constitute a subjective component, such asthe individual's complaint that he is uncomfortable wearing a particulartype of hearing aid and, therefore, only uses the hearing aidoccasionally, rather than all of the time as would be necessary toattain the full potential of rehabilitation available through use of thehearing aid. In addition, the feedback can include an objectivecomponent, such as the individual finds it difficult to initially use aparticular hearing aid but has been using it and rehabilitation progresshas been as expected.

FIG. 4 is a preferred high level method 400 for assessing physical andpersonal environment dimensions of the individual 105, quantifying themeasurement information obtained from assessment of each of thedimensions to define respective metrics from which diagnostic scores andgoal scores can be generated, and using profile information andindividual scores for at least one of the physical dimensions andpersonal environment dimensions of the individual 105 to select an auralrehabilitation plan from the plans contained in the aural rehabilitationplan records stored in plans 269. For purposes of illustration, theprocess 400 is described in connection with the operations that would beperformed using the system 200 and system 300.

Referring to FIG. 4, in step 410, the audiologist 310, using theprograms 240, assesses the individual 105 to obtain measurementinformation for all of the metrics 100. For example, an assessment ofthe personal environment dimension of speech intelligibility, whichcorresponds to the metric 113, can be performed in accordance with adiagnostic testing method of creating a training product customized foran individual that determines specific, troublesome words and sentencesbased on the individual's hearing profile, and stores the measurementinformation obtained from such testing in a database. See “SYSTEM FORAND METHOD OF TRAINING A USER TO UNDERSTAND HUMAN SPEECH CORRECTLY WITHA HEARING AID DEVICE”, U.S. Provisional Application Ser. No. 60/482,159,filed Jun. 24, 2003, assigned to the assignee of this application andincorporated by reference herein. Further in step 410, the basic profileinformation for the individual 105 is also collected and stored inindividual profile information 265.

Following step 410, in step 415 the hearing test unit 215 performs theprograms 240, or alternatively the audiologist 310 performs offlinecomputations, to process the raw measurement information obtained fromthe assessments of step 410 so as to define metrics 100 corresponding tothe respectively assessed dimensions. Preferably, the metrics 100 aredefined by quantifying the measurement information obtained for therespective dimensions in the manner described with reference to FIG. 1.In a preferred embodiment, the assessments in step 410 providemeasurement information for defining volume metric 111, pitch metric112, speech intelligibility metric 113, real-world needs metric 114,individual's critical success factors metric 115, localization metric116, appearance/performance trade-off metric 117 and quality preferencesmetric 118. The quantification of the measurement information that isperformed to define a metric preferably includes normalizing themeasurement information obtained from the assessment of each dimensioninto a signal metric that is a linear scale from lowest possible score190 to a perfect score 120. The generation of a diagnostic score for acorresponding metric, such as the metric 112, can be performed by simplysumming all scores where a perfect hearing score is 100% and a worstcase hearing is 0%. In addition, in step 415, the audiologist 310optionally uses the measurement information corresponding to a metric todefine a goal metric score 150.

Following step 415, in step 420, for each of the metrics 100, thediagnostic score 140 and any goal score 150 for the individual 105 arestored as individual test results 267.

Then in step 430, the central hearing health computer system 260determines an aural rehabilitation plan for the individual 105. Forpurposes of illustration, step 430 is performed by evaluating tablessimilar to an exemplary virtual database table 500, as shown in FIG. 5.The tables 500 are stored in the database 263, preferably in the auralrehabilitation plans 269, and represent the aural rehabilitation planspreviously prescribed to patients indexed by profile information andscores corresponding to the respective diagnostic metrics of thepatients to whom the plans were prescribed. The tables 500 further caninclude aural rehabilitation plans, with associated indexinginformation, generated by performing conventional interpolationprocesses using information representative of the previously prescribedaural rehabilitation plans and their associated indexing data. Thetables 500 are evaluated to select an aural rehabilitation plan for theindividual 105, in view of the diagnostic and goal scores and profilesof the individual for corresponding respective personal environment andphysical dimensions. Referring to FIG. 5, the table 500 includes a setof diagnostic metrics 510, which correspond to the assessed physical andpersonal environment dimensions; a set of user profiles 520 containinginformation preferably obtained during the assessments; a set ofdiagnostic metric scores 530; a set of goal metric scores 540; arehabilitation trajectory 550; and a rehabilitation plan 560.

For ease reference and clarity, the method 400 is described below inconnection with the use of previously prescribed aural rehabilitationplans stored as tables 500, and with the understanding that method 400can also include processing of aural rehabilitation plans that aregenerated using interpolation techniques and are similarly indexed inthe table 500. Referring again to FIG. 5, user profiles 520 are theprofiles of the patient with hearing loss for each diagnostic metric510. Diagnostic metric scores 530 are the patient's hearing test scoresfor each diagnostic metric 510. Goal metric scores 540 are the bestscores that the individual can expect to achieve for each diagnosticmetric 510 after hearing assistance, such as application of a hearingaid instrument, given the extent of physical loss inside the ear.Rehabilitation trajectory 550 is the step-by-step progress for theindividual to proceed from diagnostic metric scores 530 to goal metricscores 540 for each diagnostic metric 510. Rehabilitation trajectory 550further includes WK1, WK2, and WKN, which represent the progressiveimprovement of the patient for each diagnostic metric 510 on a weeklybasis from the first week to the Nth week, where N varies and is thenumber of total weeks for rehabilitation prescribed to the patient byaudiologist 310. Rehabilitation plan 560 is the plan previouslyprescribed to the patient to restore hearing and progress fromdiagnostic metric scores 530 to goal metric scores 540 alongrehabilitation trajectory 550.

In the preferred embodiment, aural rehabilitation plans 269 of database263 contain multiple copies of table 500 for at least thousands ofindividuals having hearing loss. Referring to FIG. 3, for the individual105, central hearing health computer system 260 determinesrehabilitation trajectory 550 and rehabilitation plan 560 by comparingindividual profile information 265, individual diagnostic scores 140 andindividual goal scores 130 with the information used to index previouslyprescribed rehabilitation plans, namely, profiles and scorescorresponding to respective diagnostic metrics, contained in auralrehabilitation plans 269. Based on the comparison, the system 260retrieves at least one copy of a table 500 having profiles 520,diagnostic metric scores 530 and goal metric scores 540 corresponding toone or more of the diagnostics metrics 510 that match with individualprofile information 265, individual diagnostic scores 140 and individualgoal scores 130 for the individual 105 associated with respectivelycorresponding metrics. At this point, assuming that only a single tableis selected, central hearing health computer system 260 has selected arehabilitation trajectory 550 and a rehabilitation plan 560 for theindividual 105, which is represented in the matching copy of table 500.The process of matching user profiles and scores from tables within adatabase is well known in the art, and any known technique, such as, forexample, described in U.S. Pat. No. 6,063,028, “Automated TreatmentSelection Method,” incorporated by reference herein, can be applied inthe subject invention.

Following step 430, in step 440 the audiologist 310 prescribes therehabilitation plan selected in step 430 to the individual 105. In thepreferred embodiment, audiologist 310 prescribes rehabilitation plan 560to the individual 105 over several counseling sessions, where eachcounseling session marks an improvement milestone for the individual'shearing, such that at the end of the final counseling session, theindividual's hearing is at goal score 130.

For example, if D3 in the table 500 for the individual 105 correspondsto the speech intelligibility metric 113, the correspondingrehabilitation plan 560 can be a pre-recorded compact disc that teachesthe individual 105 to listen and train his brain to interpret animproved version of a series of words and sentences to bring speechintelligibility metric 113 from diagnostic score 140 to goal score 130.Rehabilitation trajectory 550 can last for three weeks, whereaudiologist 310 meets with the individual 105 once a week to study theindividual's learning progression and to receive feedback from theindividual on adding or removing training words from the compact disc.

In a further embodiment, the plan 560 for D3 is prescribed in view ofthe plan 560 for D5, which corresponds to the critical success factorsmetric 115. By aggregating selected rehabilitation plans Into arehabilitation program, the likelihood of successful use of the compactdisc prescribed under D3 is heightened. For example, where the plan 560for D5 indicates a preference for use of electronic devices, the plan560 for D3 using a learning compact disc can be supplemented with otherelectronic devices to further promote the progress of rehabilitation, inview of the individual's preference for electronic devices.

In still a further preferred embodiment, the plan 560 for D3 isprescribed in view of the plan 560 for D7, which corresponds to thequality preferences metric 118, and the plan 560 for D1, whichcorresponds to the volume metric 111. For example, based on the selectedplans, a hearing aid for an individual with hearing loss is programmedto increase amplification gradually, over time, consistent with theimplementation of a treatment plan where the individual uses aprerecorded CD to train and learn to hear only some of the variousfrequencies that the individual previously could not hear because of theonset of hearing loss. The rehabilitation plan for D3 sets theexpectation for rehabilitation for the individual to a level associatedwith relearning a first set of frequencies. The relearning is achievedover a first period through use of the CD, which is specificallyprogrammed to address only the first set of frequencies, the and thehearing aid that has been programmed to a first amplification level. Asa result, the individual is highly likely to adhere to the overallrehabilitation program, and use the hearing aid which is programmed inview of the individual's personal environment dimensionscharacteristics, because the individual will be able to note thatrehabilitative progress is being made. The recognition of rehabilitativeprogress by an individual is particularly critical during the initialperiod of rehabilitation, because during this period the individual ismost likely to become frustrated by a rehabilitation plan, such as onerequiring the use of a hearing aid, and stop using the hearing aid ornot perform the treatments prescribed by the plans. After the firstrehabilitation goal is reached, the individual can be re-assessed andbased on the reassessment, the hearing aid would be programmed toincrease amplification and a CD specific to other frequencies would beprescribed. The iteration of this process maintains the individual'sinterest and incentive to continue with rehabilitation, because thelevel of rehabilitation reached at each stage is consistent with whatthe individual considers to be satisfactory.

In a further preferred embodiment, if the system 260 retrieves severalselected plans, the audiologist uses his judgment to prescribe one ormore of the selected plans that should lead to the most improvement withthe least amount of effort by the individual.

In an alternative preferred embodiment, the system 260 uses thediagnostic and goal scores of the individual 105 to compute a cumulativediagnostic score and a cumulative goal score, and uses the cumulativescores to adjust the rehabilitation plans prescribed to the individual.For example, if the cumulative goal score is relatively large and thecumulative diagnostic score is relatively small, the rehabilitationplans can be customized to ensure the individual is aware that muchrehabilitative effort will be needed and prescribe treatments thatshould achieve highly noticeable change and do not initially overwhelmthe individual to cause the individual to abandon a rehabilitationprogram.

Thus, the scores that can generated for corresponding personalenvironment and physical dimensions characteristics of an individualhelp customize and optimize an overall rehabilitation program for anindividual. The scores constitute predictors of what treatments, ie,rehabilitation plans from the database 263, when prescribed to theindividual 105, will result in the individual using the hearing aid andadhering to treatments directed by the selected rehabilitation plans soas to successfully attain a level of rehabilitation that is satisfactoryto the individual.

Following step 440, in step 450 the audiologist 310 updates the database263 based on any feedback that the individual 105 provides based on theaural rehabilitation plan suggested in step 440 or the resultingprogress of rehabilitation. The feedback can be provided before, duringor after the individual 105 implements the prescribed plan. The updatingof the database 263 can be done through standard PC input/output devicessuch as keyboard 230 and monitor 235. This feedback is particularlyuseful to annotate the individual's aural rehabilitation plan record, orthe plan record containing the selected aural rehabilitation planprescribed to the individual, to ensure the completeness and accuracy ofthe aural rehabilitation plan records in the aural rehabilitation plans269 within database 263.

The updating can include, for example, defining a new auralrehabilitation plan record in a table 500 for the individual. Forexample, the record can be for the diagnostic metric D1 and identify atreatment plan in the plan 560 that is a modified version of the plansuggested in the step 440. In a further preferred embodiment, to ensurethe individual's 105 satisfaction, in all the counseling sessions, theindividual 105 can provide feedback and the audiologist uses thefeedback to update the rehabilitation plan 560 and rehabilitationtrajectory 550 based on the individual's experience.

In a further preferred embodiment, the computer system 260 processes theinformation in the database 263 to generate predictive modeling dataassociated with use of hearing aids and hearing aid accessories.Specifically, the computer system 260 processes the informationcontained in the profiles 520, the scores 530 and 540 and thecorresponding plans 560 for the respective metrics 510 in each of thetables 500 in the database 263 to predict how an individual, having aprofile and associated scores for each of the respective diagnosticmetrics, will use a particular hearing aid and what hearing aidaccessories can be cross-sold to the individual based on how theindividual will use the hearing aid. Methods of using predictivemodeling to increase sales revenues are well known in the art. See, forexample, U.S. Pat. No. 5,930,764, incorporated by reference herein.

Although preferred embodiments of the present invention have beendescribed and illustrated, it will be apparent to those skilled in theart that various modifications may be made without departing from theprinciples of the invention.

1. A method for selecting a rehabilitation plan for an individual havinga medical condition comprising: assessing personal environmentdimensions and physical dimensions of an individual having a medicalcondition to obtain measurement information; defining diagnostic metricscorresponding to the respective assessed dimensions based on themeasurement information; generating scores for the individual for therespective metrics based on the measurement information; and selecting arehabilitation plan for the individual using the score corresponding toat least a first of the assessed dimensions of the individual.
 2. Themethod of claim 1 wherein the selecting further comprises: searching adatabase containing rehabilitation plans for the medical condition,wherein the database includes, for respective physical dimensions andpersonal environment dimensions associated with the medical condition,scores corresponding to respective stored rehabilitation plans, andmatching the score for the at least first assessed dimension for theindividual with a score in the database corresponding to a storedrehabilitation plan associated with the at least first assesseddimension, wherein the matched rehabilitation plan is selected as arehabilitation plan for the individual.
 3. The method of claim 1,wherein the generated scores and the scores in the database eachcomprise at least one of a diagnostic score and a goal score and thestored rehabilitation plans comprise previously prescribedrehabilitation plans and, optionally, interpolated rehabilitation plans.4. The method of claim 1, wherein the measurement information for theassessed dimensions of the individual includes profile information. 5.The method of claim 2, wherein the measurement information for theassessed dimensions of the individual includes profile information andwherein the database includes, for the respective physical dimensionsand personal environment dimensions, profile information correspondingto the stored rehabilitation plans that correspond to the respectivescores, and wherein the database further includes annotation informationfor at least one of the stored rehabilitation plans.
 6. The method ofclaim 2 further comprising: updating the database based on feedbackreceived from the individual for which the rehabilitation plan wasselected.
 7. The method of claim 1 further comprising: selecting aninstrument for use in rehabilitating the individual based on theselected rehabilitation plan.
 8. A method for selecting an auralrehabilitation plan for an individual with hearing loss comprising:assessing personal environment dimensions and physical dimensions of anindividual with hearing loss to obtain measurement information; definingdiagnostic metrics corresponding to the respective assessed dimensionsbased on the measurement information; generating scores for theindividual for the respective metrics based on the measurementinformation; and selecting an aural rehabilitation plan for theindividual using the score corresponding to at least a first of theassessed dimensions of the individual.
 9. The method of claim 8, whereinthe selecting further comprises: searching a hearing loss rehabilitationplan database, wherein the database includes, for respective physicaldimensions and personal environment dimensions associated with hearingloss, scores corresponding to respective stored aural rehabilitationplans, and matching the score for the at least first of the assesseddimensions for the individual with a score in the database correspondingto a stored aural rehabilitation plan associated with the at least firstassessed dimension, wherein the matched aural rehabilitation plan isselected as an aural rehabilitation plan for the individual.
 10. Themethod of claim 9, wherein the defining the diagnostic metrics includesnormalizing the measurement information obtained for each of theassessed dimensions into a linear scale signal metric, wherein thegenerated scores and the scores in the database each comprise at leastone of a diagnostic score and a goal score and wherein the stored auralrehabilitation plans comprise previously prescribed aural rehabilitationplans and, optionally, interpolated aural rehabilitation plans.
 11. Themethod of claim 10, wherein the measurement information for the assesseddimensions of the individual includes profile information, wherein thedatabase includes, for the respective physical dimensions and personalenvironment dimensions, profile information corresponding to the auralrehabilitation plans that correspond to the respective scores andwherein the database further includes annotation information for atleast one of the stored rehabilitation plans.
 12. The method of claim 8,wherein the personal environment dimensions associated with hearing lossinclude at least two of speech intelligibility, real world needs,critical success factors, localization, appearance/performancetrade-offs and quality preferences.
 13. The method of claim 8 furthercomprising: selecting a programmable hearing aid for use inrehabilitating the individual based on the selected rehabilitation plan.14. A system for selecting a rehabilitation plan for an individualhaving a medical comprising: a rehabilitation plan selection meanshaving communications capabilities, wherein the selection means includesa rehabilitation plan database containing, for respective physicaldimensions and personal environment dimensions associated with a medicalcondition, scores corresponding to respective stored rehabilitationplans; and wherein the selection means, in response to a selectionrequest including a score corresponding to at least a first of assessedphysical and personal environment dimensions of a individual having themedical condition, selects a rehabilitation plan for the individual bymatching the score for the first assessed dimension of the individualwith a score in the database corresponding to a stored rehabilitationplan associated with the at least first assessed dimension, wherein thematched rehabilitation plan is selected as a rehabilitation plan for theindividual.
 15. The system of claim 14 further comprising: a dimensionsassessment means having communications capabilities and for coupling tothe selection means, wherein the assessment means includes programs forassessing at least one of physical dimensions and personal environmentdimensions of the individual requestor to obtain measurementinformation, wherein metrics corresponding to the respective assesseddimensions can be defined and scores for the respective metrics can begenerated for the individual based on the measurement information, andwherein the assessment means is operable to transmit the selectionrequest to the selection means.
 16. The system of claim 15, wherein thegenerated scores and the scores in the database each comprise at leastone of a diagnostic score and a goal score, wherein the storedrehabilitation plans comprise previously prescribed rehabilitation plansand, optionally, interpolated rehabilitation plans, and wherein thedatabase further includes annotation information for at least one of thestored rehabilitation plans.
 17. The system of claim 14, wherein theselection means updates the database based on feedback or rehabilitativeprogress results concerning the individual requestor for whom therehabilitation plan was selected.
 18. The system of claim 14, whereinthe selection means, based on the score of the requestor for the atleast first assessed dimension, identifies an instrument for use inconjunction with the selected rehabilitation plan.
 19. A system forselecting an aural rehabilitation plan for an individual having hearingloss comprising: an aural rehabilitation plan selections means havingcommunications capabilities, wherein the selection means includes anaural rehabilitation plan database containing, for respective physicaldimensions and personal environment dimensions associated with hearingloss, scores corresponding to respective stored aural rehabilitationplans; and wherein the selection means, in response to a selectionrequest including a score corresponding to at least a first assessedphysical and personal environment dimension of an individual havinghearing loss, selects an aural rehabilitation plan for the individual bymatching the score for the first assessed dimension of the individualwith a score in the database corresponding to a stored auralrehabilitation plan associated with the at least first assesseddimension, wherein the matched rehabilitation plan is selected as theaural rehabilitation plan for the individual.
 20. The system of claim 19further comprising: a dimensions assessment means having communicationscapabilities and for coupling to the selection means, wherein theassessment means includes programs for assessing at least one ofphysical dimensions and personal environment dimensions of theindividual requestor to obtain measurement information, wherein metricscorresponding to the respective dimensions can be defined and scores forthe respective metrics can be generated for the individual based on themeasurement information, wherein the assessment means is operable totransmit the selection request to the selection means, and wherein thedatabase further includes annotation information for at least one of thestored rehabilitation plans.
 21. The system of claim 20, wherein theassessed personal environment dimensions of the individual with hearingloss includes at least two of speech intelligibility, real-world needs,critical success factors, localization, appearance and performancetrade-offs and quality preferences.
 22. A system for selecting arehabilitation plan for an individual with a medical conditioncomprising a database accessible via communication means, wherein thedatabase includes individual profiles, diagnostics scores, goal scoresand annotation information corresponding to respective previouslyprescribed rehabilitation plans for respective physical dimensions andpersonal environment dimensions of an individual with the medicalcondition, wherein the database is searchable for matching individualprofiles, diagnostic scores and goal scores associated with at least afirst of assessed physical dimensions and personal environmentdimensions of an individual to profiles, diagnostic scores and goalsscores that correspond to respective previously prescribedrehabilitation plans for the at least first assessed dimension, whereinthe corresponding rehabilitation plan is selected as a rehabilitationplan for the requester.